The eutectic mixture local anesthetics (EMLA) cream is more effective on venipuncture pain compared with lidocaine tape in the same patients

Abstract

Introduction: Although venous cannulation is imperative during perioperative period, it inevitably causes venipuncture pain. Eutectic mixture local anesthetics (EMLA) has been used to reduce this pain, and various studies have been conducted to evaluate the efficacy of EMLA. But these studies did not elucidate the effect of EMLA exactly, because there were large individual differences in pain sensitivity. The aim of this study is to accurately evaluate the efficacy of EMLA cream for venipuncture pain relief compared with lidocaine tape in the same patients. Methods: Participants were randomly allocated into EL or LE group. Participants received EMLA cream at one side dorsum of hand and lidocaine tape at another dorsum of hand before entering operation room. Local anesthetics were strictly applied according to their manufacturers' instruments, respectively. In the EL group, participants received venipuncture at EMLA cream site firstly. In LE group, participants, conversely, received venipuncture at lidocaine tape site firstly. Before anesthetic induction, local anesthetics were removed followed by venous cannulations. After cannulation, participants evaluated the pain by visual analog scale (VAS) and verbal rating scale (VRS).The primary outcome was VAS, and the secondary outcome was VRS. Results: Data from 24 patients were analyzed. The VAS of EMLA cream was significantly lower than that of lidocaine tape (4 [0-18] vs 17 [8-45], p = 0.001, 95% CI − 25 to − 6). The VRS of EMLA cream was also significantly lower than that of lidocaine tape (2 [1-2] vs 2 [2-3], p = 0.002, 95% CI − 0.8 to − 0.2). The local skin adverse events were observed in five patients at EMLA cream applied hands. Conclusions: We conducted a comparative study to elucidate the efficacy of EMLA cream for venipuncturepain comparing with lidocaine tape in the same patients. Our results strongly suggest that EMLA cream is more effective for venipuncture pain relief than lidocaine tape.

Enhancing Intradermal Delivery of Lidocaine by Dissolving Microneedles: Comparison between Hyaluronic Acid and Poly(Vinyl Pyrrolidone) Backbone Polymers

“…LiH has been marketed in the form of an anesthetic cream, such as 5% EMLA™ [ 4 , 16 ]. Nevertheless, LiH should be combined with prilocaine to improve its penetration [ 17 ]. LiH has also been formulated into different types of conventional topical dosage forms, namely gel and spray.…”

Use of EMLA cream for skin anesthesia and epidural insertion in the patients with cesarean delivery

“…EMLA cream was introduced 1990’ and proved to be effective for venipuncture and superficial procedure. [ 6 ] In the field of regional anesthesia, the implication of EMLA cream was reported for spinal puncture. [ 7 ] Sharma SK et al .…”

Efek Eutectic Mixture of Local Anesthetics (EMLA) terhadap Nyeri Penyuntikan Jarum Spinal

“…Penelitian menunjukkan bahwa Eutectic mixture of local anesthetics (EMLA) memiliki efek analgesik yang baik dalam pemasangan jalur intravena, pungsi lumbar, prosedur bedah dermatologi dan kosmetik, serta prosedur medis minor lainnya. 2,4,5,[6][7][8][9] Keuntungan EMLA adalah aplikasi yang mudah dan sederhana, sedangkan kerugiannya adalah mula kerja yang cukup lama untuk mencapai efek analgetik yang optimal. Pada penelitian ini dipilih EMLA karena mudah didapat dan diaplikasikan.…”

“…Penggunaan EMLA sebelum penyuntikan jarum spinal telah dilakukan pada penelitian sebelumnya seperti pada tindakan pungsi lumbar dan pasien yang menjalani prosedur brachytherapy dalam anestesi spinal. [6][7][8][9] Teknik anestesi spinal merupakan teknik anestesi yang sering dilakukan dan memberikan banyak keuntungan untuk operasi tubuh bagian bawah. Ketakutan akan nyeri dan kerusakan saraf merupakan 2 faktor utama yang memengaruhi penerimaan pasien untuk dilakukan tindakan anestesi spinal untuk yang pertama kali.…”

“…Pada penelitian ini faktor perancu seperti tingkat kecemasan, usia, jenis kelamin, indeks massa tubuh dilakukan pengukuran. 7 Keterbatasan penelitian ini adalah tidak dilakukan pengukuran kedalaman penyuntikan jarum spinal. Penyuntikan jarum spinal akan menembus lapisan epidermis, dermis, subkutan, ligamentum, dan melewati celah di antara tulang vertebra.…”